VACCINATION – EVALUATION OF EXPEDIENCY AND RISKS
DOI:
https://doi.org/10.11603/1681-2727.2019.2.10329Keywords:
immunoprophylaxis, vaccines, vaccination risks, vaccination expediency, postvaccinal complication, prediction of vaccination complications, individual vaccination algorithmAbstract
The study is devoted to the modern problems of immunoprophylaxis of controlled infections. The reviewed issues include problems of individual vaccination, evaluation of its expediency and necessity, prognosis and prevention of severe postvaccinal complications.
The work provides the data (considering the WHO recommendations) on the individual protective levels of specific antibodies in human serum regarding specific controlled infections. The study highlights the necessity to standardize the indicators of the protective antibodies levels identified by different research methods, and the ways of solving the issue are suggested. The data on the correspondence between the collective and individual immunity indicators are presented.
The given data are based on the determining of the specific protective antibodies levels, which substantiate the procedure of expediency, necessity and risks assessment for individual immunization to prevent a specific controlled infection in a particular patient.
The possibility of predicting severe allergic postvaccinal reactions using the «old» and unjustly forgotten methods of assessment is demonstrated. The restoration and methodology of the immunolysis reaction with vaccine antigens are suggested.
The necessity of the practical implementation of individual vaccination and revaccination programs is objectively substantiated. The following algorithm is proposed for individual immunoprophylaxis: initially, an assessment of the specific vaccination necessity, which is determined by the level of specific protective antibodies (considering the WHO recommendations); at the second stage – an assessment of the vaccination expediency; at the third stage, a comprehensive assessment of the possibility of the specific immunoprophylaxis, taking into account clinical contraindications, as well as individual risks, side effects and the risk of anaphylactic reactions development when using a particular vaccine in a particular patient.
The proposed algorithm and the use of methods for immunopathological reactions prediction do not give a 100 % safety guarantee, but undoubtedly reduces the immunoprophylaxis risks to the possible minimum. The suggested measures most importantly allow both the patient and physician to make a conscious decision on the use of a specific vaccine. In case of the development of non-predictable complications the measures solve the problem of legal liability since all possible means and ways to prevent them were undertaken.
The creation of relevant regulatory documents with detailed instructions, in contrast to brief protocols, is strongly recommended. The documents are supposed to describe the algorithm of individual immunization with the use of modern methods of reliable postvaccinal risks prediction.
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